Concomitant mutations linked to poorer response in EGFR mutation-positive NSCLC
medwireNews: In patients with epidermal growth factor receptor (EGFR)-mutated non-small-cell lung cancer (NSCLC), the presence of concomitant mutations in other cancer-related genes is associated with worse outcomes in response to EGFR tyrosine kinase inhibitors (TKIs), Chinese research suggests.
Of 58 patients with metastatic NSCLC who had received first-line EGFR TKIs, over half (55%) had concomitant genetic alterations as shown by next-generation sequencing of cell-free DNA obtained prior to the initiation of treatment.
Patients with co-occurring mutations at baseline had a significantly poorer objective response rate (44 vs 77%), as well as significantly shorter progression-free survival (median 6.20 vs 18.77 months) and overall survival (median 22.70 months vs unreached) than their counterparts with mutations in EGFR alone.
Li Zhang, from the Sun Yat-sen University Cancer Center in Guangzhou, and team write in JAMA Oncology that their “results might challenge the current view that EGFR-mutant NSCLC is a single-oncogene–driven disease.”
They add: “Our study highlights the importance of deploying multiplex molecular profiling and conducting research on the use of polytherapy or sequential therapy to address the coalterations that drive drug resistance.”
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